Division of Hospital Medicine, University of California San Francisco, San Francisco, California, USA.
Division of Hospital Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA.
J Hosp Med. 2023 Apr;18(4):329-336. doi: 10.1002/jhm.13074. Epub 2023 Mar 6.
The hospitalist workforce has been at the forefront of the pandemic and has been stretched in both clinical and nonclinical domains. We aimed to understand current and future workforce concerns, as well as strategies to cultivate a thriving hospital medicine workforce.
DESIGN, SETTING, AND PARTICIPANTS: We conducted qualitative, semistructured focus groups with practicing hospitalists via video conferencing (Zoom). Utilizing components from the Brainwriting Premortem Approach, attendees were split into small focus groups and listed their thoughts about workforce issues that hospitalists may encounter in the next 3 years, identifying the highest priority workforce issues for the hospital medicine community. Each small group discussed the most pressing workforce issues. These ideas were then shared across the entire group and ranked. We used rapid qualitative analysis to guide a structured exploration of themes and subthemes.
Five focus groups were held with 18 participants from 13 academic institutions. We identified five key areas: (1) support for workforce wellness; (2) staffing and pipeline development to maintain an adequate workforce to match clinical growth; (3) scope of work, including how hospitalist work is defined and whether the clinical skillset should be expanded; (4) commitment to the academic mission in the setting of rapid and unpredictable clinical growth; and (5) alignment between the duties of hospitalists and resources of hospitals. Hospitalists voiced numerous concerns about the future of our workforce. Several domains were identified as high-priority areas of focus to address current and future challenges.
医院医生团队一直处于大流行的前沿,在临床和非临床领域都承受着压力。我们旨在了解当前和未来的劳动力问题,以及培养蓬勃发展的医院医学劳动力的策略。
设计、设置和参与者:我们通过视频会议(Zoom)对执业医院医生进行了定性、半结构化的焦点小组。利用头脑风暴预死后方法的组成部分,与会者被分成小焦点小组,列出他们对医院医生在未来 3 年内可能遇到的劳动力问题的想法,确定医院医学社区的最高优先级劳动力问题。每个小团体讨论最紧迫的劳动力问题。然后,这些想法在整个小组中进行了分享和排名。我们使用快速定性分析来指导对主题和子主题的结构化探索。
在 13 所学术机构中,我们进行了 5 次焦点小组会议,共有 18 名参与者。我们确定了五个关键领域:(1)支持劳动力健康;(2)人员配置和人才培养,以维持足够的劳动力以匹配临床增长;(3)工作范围,包括如何定义医院医生的工作以及是否应该扩大临床技能;(4)在快速和不可预测的临床增长环境下,对学术使命的承诺;(5)医院医生的职责与医院资源之间的一致性。医院医生对我们劳动力的未来表示了诸多担忧。确定了几个领域作为解决当前和未来挑战的重点关注领域。